Pregnancy 1 Flashcards
Describe maternal physiology during the first half of pregnancy.
- Anabolism occurs - maternal growth supports her tissues and development of placenta
- total body water increases from 7L to 10L for blood, amniotic fluid, extracellular fluid
- elevated insulin increases lipogenesis and glycogenesis in tissues (increased appetite)
Describe maternal physiology during the second half of pregnancy
- 90% of fetal growth
- catabolism due to reduced insulin production (less glycogenesis and lipogenesis)
- maternal insulin resistance support higher blood sugar, **glucose = preferred fuel of fetus **
- increased exercise tolerance from more fluid
Describe the placenta, including the origin, structure, transport functions, and importance. Describe the general structure of the placenta. Do the maternal and fetal bloods typically mix during gestation?
-Weighs 2-3 lbs
- serves as barrier to harmful substances
- fights infections
- provides nutrients and oxygen to fetus
- removes waste products from fetus
- secretes hormones: progesterone, estrogen, human chorionic gonadotropin
no mixing of blood until delivery
There are 4 pregnancy hormones that have key roles in pregnancy. List the hormones and describe their roles.
1) Progesterone: growth of breast and endometrium, maintains placenta, promotes lipid accumulation, loosens joints & ligaments
2) Estrogen: growth of uterus, breast, increases circulation, increases protein and lipid synthesis and lipid storage
3) hCG: pregnancy test hormone, growth of endometrium, maintains corpus luteum
4) CL: produces estrogen & progesterone
What are the recommended weight gain in pounds for pregnancy for women who are underweight, normal weight, overweight, or obese? Include whether rate or total amount gained is most important.
- Underweight BMI - 28-40 lbs total, 1 lbs weekly
- Normal BMI - 25-35 lbs total, 1 lb weekly
- Overweight BMI - 15-25 lbs total, .6 lb weekly
- Obese BMI - 11-20, .5 lbs weekly
The overarching takeaway is that pregnancy is not the time for someone to lose weight, regardless of BMI
Describe the components of weight gain and their weights for delivery of an 8-pound infant in pounds.
25-35 lbs Weight gain from 8 lbs baby includes:
- infant 8
- placenta 2-3
- blood 4
- uterus & supporting muscles 2-5
- Breast tissue - 2-3
- Amniotic fluid 2-3
- Maternal fat 5-9
Discuss postpartum weight retention. What is normal? Who is at higher risk? What are interventions to avoid health risks?
- it is typical to retain 6-7 lbs 12 months later
- long term weight retention is most common among: low-income, western diet, multiple births, inactivity, breast feeding for less than 20 weeks
- interventions: nutrition counseling and education, increased physical activity, improved diet
Describe the overall calorie requirements for a pregnancy. What are requirements for the first, second and third trimesters? How many calories do most pregnant women need (give a range)?
- 1st trimester: no increase
- 2nd trimester: +340 kcal/day
- 3rd trimester: +452 kcal/day
- most pregnant women need 2200-2900 kcal/day
Physical activity. Describe the 2018 Physical Activity Guidelines for Americans for pregnant women. What is added by the ACOG? Be able to provide specific advice regarding different activities, as discussed in class (WebMD). Who should not exercise?
For all healthy pregnant women:
* get at least 2.5 hours of moderate-intensity aerobic activity/week, preferably spread throughout
* engage in moderate strength training
* Avoid high altitudes, move smoothly, beware of high temperatures, no scuba diving
